Discussions are currently underway for the simultaneous revision of fees for health care, long-term care, and welfare services for persons with disabilities from April to June 2024. Key issues to be discussed in this revision include how to secure financial resources in light of factors such as the increasing elderly population and decreasing working-age population in Japanese society, how to address shortages of service providers, what kind of coordinated delivery system is needed for health care, long-term care, and welfare for persons with disabilities, and how to effectively and efficiently utilize limited resources such as human resources, materials, and funds.

Health and Global Policy Institute (HGPI) launched the Planetary Health Project in fiscal year 2022, engaging in discussions with multiple stakeholders from industry, government, academia, and the public. Changes in the Earth’s environment, including climate change, have become urgent challenges that threaten human health. In sectors such as healthcare, long-term care, and welfare services for persons with disabilities, where government control over goods and services is exercised, it is necessary for governments to provide direction to make changes that are sustainable and resilient to climate change, taking into account not only financial but also environmental aspects.

In this proposal, we recommend the following four points from a planetary health perspective.

• Recommendation 1: Revise and increase basic hospitalization premiums and other surcharges to support the introduction of renewable energy
• Recommendation 2: Incentivize the green procurement of medical supplies and materials
• Recommendation 3: Expand the Functional Enhancement Premium to include new reimbursements for ascertaining and evaluating home living environments
• Recommendation 4: Expand long-term care service fee schedule premiums to support enhancements to home living environments (for heat stroke prevention, etc.)